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Metabolic Syndrome and COVID-19 Mortality Among Adult Black Patients in New Orleans
Authors:John Xie  Yuanhao Zu  Ala Alkhatib  Thaidan T Pham  Frances Gill  Albert Jang  Stella Radosta  Gerard Chaaya  Leann Myers  Jerry S Zifodya  Christine M Bojanowski  Nassir F Marrouche  Franck Mauvais-Jarvis  Joshua L Denson
Abstract:OBJECTIVECoronavirus disease 2019 (COVID-19) mortality is high in patients with hypertension, obesity, and diabetes. We examined the association between hypertension, obesity, and diabetes, individually and clustered as metabolic syndrome (MetS), and COVID-19 outcomes in patients hospitalized in New Orleans during the peak of the outbreak.RESEARCH DESIGN AND METHODSData were collected from 287 consecutive patients with COVID-19 hospitalized at two hospitals in New Orleans, LA, from 30 March to 5 April 2020. MetS was identified per World Health Organization criteria.RESULTSAmong 287 patients (mean age 61.5 years; female, 56.8%; non-Hispanic Black, 85.4%), MetS was present in 188 (66%). MetS was significantly associated with mortality (adjusted odds ratio aOR] 3.42 95% CI 1.52–7.69]), intensive care unit requirement (ICU) (aOR 4.59 CI 2.53–8.32]), invasive mechanical ventilation (IMV) (aOR 4.71 95% CI 2.50–8.87]), and acute respiratory distress syndrome (ARDS) (aOR 4.70 95% CI 2.25–9.82]) compared with non-MetS. Multivariable analyses of hypertension, obesity, and diabetes individually showed no association with mortality. Obesity was associated with ICU (aOR 2.18 95% CI 1.25–3.81]), ARDS (aOR 2.44 95% CI 1.28–4.65]), and IMV (aOR 2.36 95% CI 1.33–4.21]). Diabetes was associated with ICU (aOR 2.22 95% CI 1.24–3.98]) and IMV (aOR 2.12 95% CI 1.16–3.89]). Hypertension was not significantly associated with any outcome. Inflammatory biomarkers associated with MetS, CRP and lactate dehydrogenase (LDH), were associated with mortality (CRP aOR 3.66] 95% CI 1.22–10.97] and LDH aOR 3.49] 95% CI 1.78–6.83]).CONCLUSIONSIn predominantly Black patients hospitalized for COVID-19, the clustering of hypertension, obesity, and diabetes as MetS increased the odds of mortality compared with these comorbidities individually.
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